Individual provider Active NPI

Kirsten Marie Johnson, MD/PHD

  • Dermatology Physician
  • Gahanna, OH
National Provider Identifier
1639798812
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35.153524 Issued in OH
Practice address
540 Officenter PL Ste 240
Gahanna, OH 43230-5317
Phone
(614) 293-1707
Fax
(614) 293-1716
NPI assigned
Apr 8, 2020
Last updated
Oct 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35.153524 OH Primary

Addresses

Primary practice location

540 Officenter PL Ste 240
Gahanna, OH 43230-5317

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-1707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250605000341 OH Practitioner - Dermatology 9931523750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Ohio State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Hospitals Medical Group IncGroup PAC ID 4789682493, 2,248 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions42
Removal or shaving of skin growth1-10
Skin biopsy15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35.153524OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osu Internal Medicine, LLC Dermatology CurrentSince Jul 1, 2025 Accepting new patients

Locations

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

3900 Stoneridge Ln
Dublin, OH 43017
Phone (614) 366-5001

540 Officenter Pl
Gahanna, OH 43230

540 Officenter Pl
Ste 240
Gahanna, OH 43230
Phone (614) 688-9542

Interoperability endpoints

  • Direct secure messaging: kjohnson624540@direct.osumc.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1639798812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-1707",
            "fax_number": "614-293-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 OFFICENTER PL STE 240",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432305317",
            "telephone_number": "614-293-1707",
            "fax_number": "614-293-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIRSTEN",
        "middle_name": "MARIE",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.153524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

Verify at the official NPI Registry.